How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,047 to $5,623Professionalmedian $1,622 · 10th to 90th $891 to $2,512
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $7,244.36 | Facility | None | $1,096.48 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,380.38 | Professional | None | $707.95 | $1,096.48 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,737.80 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,995.26 | $2,511.89 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $1,621.81 | Professional | None | $676.08 | $1,174.90 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $1,995.26 Typical High $5,248.07 | Facility | None | $1,047.13 | $1,995.26 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,905.46 Typical High $5,370.32 | Professional | None | $912.01 | $1,905.46 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,995.26 | $2,454.71 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,737.80 | $2,187.76 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $6,165.95 | Facility | None | $724.44 | $3,090.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $2,344.23 | Professional | None | $794.33 | $1,174.90 | $2,344.23 |
Wellmark Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,479.11 | $1,949.84 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $549.54 Typical High $691.83 | Professional | 52 · Reduced service | $354.81 | $549.54 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $218.78 Typical High $275.42 | Professional | 53 · Discontinued | $141.25 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $1,023.29 | Professional | 54 · Surgery only | $524.81 | $831.76 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $204.17 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $109.65 Typical High $138.04 | Professional | 56 · Pre-op care only | $70.79 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $954.99 |
Where Iowa sits
The same service costs 3.7 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $6,113DE $1,645
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.